Researchers from The Floating Hospital for Children at Tufts Medical Center and Harvard School of Public Health set out to examine sustained improvements six months after a 40-session, in-school computer attention training intervention using neurofeedback or cognitive training (CT).
The study included 104 elementary school students with attention-deficit/hyperactivity disorder (ADHD), aged 7 to 11 years and attended one of 19 public elementary schools in the greater Boston area.
The students randomly assigned to one of three groups; neurofeedback, cognitive training or a control group. The neurofeedback and cognitive group received three 45 minute sessions each week and the control group received no treatment.
All students were evaluated at six months via parent questionnaires and a systematic double-blinded classroom observation (Behavioral Observation of Students in Schools) conducted by researchers.
Neurofeedback is direct training of brain function, by which the brain learns to function more efficiently. Neurofeedback in this study involved measuring and giving feedback on a child’s brain wave activity while the child “plays” or focuses on a computer game revolving around attention activities. The child is asked to try to focus every time feedback information indicates that attention is wavering.
Cognitive training involves completing a variety of computerized exercises specifically designed to improve cognitive functioning in areas such as sustained attention, thinking before acting, visual and auditory processing, listening, reading areas in which those with ADHD, brain injuries or learning disability persons have difficulties.
Parent response rates were 90% at the 6-month follow-up. At the six month follow-up neurofeedback participant’s maintained significant improvements on Conner’s 3-P (34% improvement), Executive Functioning ES (25%), Hyperactivity/Impulsivity (23%) and BRIEF subscales including the Global Executive Composite (31%). which remained significantly greater than gains found among children in CT and control conditions.
Children in the cognitive training group showed delayed improvement ratings only on Conner’s 3-P Executive Functioning (18%) and 2 BRIEF subscales.
At the 6-month follow-up, neurofeedback participants maintained the same stimulant medication dosage however; those in the cognitive training group and control group had significant increases in medications.
In their conclusion the researchers write “Neurofeedback participants made more prompt and greater improvements in ADHD symptoms, which were sustained at the 6-month follow-up, than did CT participants or those in the control group. This finding suggests that neurofeedback is a promising attention training treatment for children with ADHD.”
In regards to the neurofeedback group Dr. Naomi Steiner, MD, Developmental-Behavioral Pediatrician at Floating Hospital for Children and Assistant Professor at Tufts University School of Medicine commented “They showed significant improvements in attention and executive function. This study suggests that neurofeedback works, and you can actually do it in schools.”
“The cognitive attention training group improved a little bit but not as much as the neurofeedback group, and not on as many scales, “she added as related by HealthDay.
“This could change the way we think about the brain, and change the way we help students and adults with ADHD,” Steiner said.
These findings are published online Feb. 17 and in the March print issue of Pediatrics.